How hyperthyroidism has changed the life of 17-year-old boy

From a healthy, avid footballer to taking 19 tablets every day.

That is now the life of 17-year-old Iyaad Faheed after he was diagnosed with hyperthyroidism.
Even though he fears needles, Mr Faheed has learnt to pinch his skin and inject insulin, an essential part of the daily regime of many people with diabetes.

Because of hyperthyroidism, the Form Three student has to get treatment for diabetes and hypertension.

Mr Faheed talks about his struggles before and after finding out about the little-known disease that has drastically changed his life.

“I was diagnosed with an overactive thyroid (hyperthyroidism) in June of this year at the age of 17, but looking back, it must all have started at the beginning of 2021. At first, I didn't realise anything was wrong, or that I had a problem.

I have always been an active person. I started playing football in primary school, and at one point, the English football club Everton wanted to scout me.

I was also a bright student, so after my Kenya Certificate of Primary Education (KCPE), I landed a spot at the prestigious Kabarak High School in Nakuru.
Here too, in Form One, I joined the senior football team. My academic performance was brilliant; I was an A student.

However, things started to change during my second year, but I thought it was just adolescence kicking in.

I started feeling exhausted during the game. I love football. Instead of the 90 minutes, I used to play; I started doing less than 45 minutes. I frequently had headaches on the left side, which affected my eyes and they would get blurry sometimes.

The headaches were followed by nose bleeding. I would take painkillers from the school sanatorium, downplaying the severity of my pain. I didn't want to bother my parents with headaches and nosebleeds; they already had enough on their plates. Even though Mom kept it from us, I knew she was ill because I had come across her medical documents, so I did not want to burden her even more. But looking back, I wish I had spoken out earlier.

With all this happening, my grades started dropping to B, which worried my parents.
They even enrolled me in a remedial class, but nothing changed. My grades kept dropping. During the school academic day, every teacher complained about my grades.

But they did not realise that my attention span was that of a gnat. I would be attentive in class, and the next minute I would doze off while the teacher was still teaching.
My deskmate kept asking what was wrong with me. That question bothered me, too, because I did not understand what was happening to me.

At some point, the school management thought I was taking drugs. This got into my head until I started believing that maybe I might have unknowingly taken drugs while attending a friend's or relative's party during the holiday.
One day, I got so agitated that I insisted on undergoing a drug test, and it came back clear, no drug was found in my bloodstream.

This year, I started developing other symptoms. My eyes started bulging, and I would tremble when I got angry. I started wearing glasses to hide the bulging eyes. They made me uncomfortable before the girls. What was happening to me made me feel secluded. This troubled me because I am a naturally talkative and outgoing person. This did not augur well for my mental well-being.

One day in June, while I was home on holiday just relaxing with my siblings, I got really ill and was rushed to the hospital, where my mother asked the doctors to conduct all possible tests.
It was then that I was diagnosed with hyperthyroidism. I learnt that a thyroid storm, a rare health condition resulting from untreated hyperthyroidism, had led to my hospitalisation.
A thyroid storm is a set of symptoms that could be life-threatening, like a fast heart rate, high blood pressure, and fever.

When my doctor said I had hyperthyroidism, I was happy because I now knew what was wrong with me and relieved that there was treatment for my illness,” concluded Mr Faheed.
"Hyperthyroidism is when your thyroid gland doesn't work right. The thyroid gland is an organ in the front of your neck that makes the hormones that control how your body uses energy. If you have high thyroid levels, it means that your thyroid gland is overactive and is making more thyroid hormones than your body needs, which causes hyperthyroidism," said Dr Rosslyn Ngugi, a consultant physician endocrinologist.

According to Dr Ngugi, the thyroid is a small, butterfly-shaped gland in the neck that makes chemicals called hormones.
Due to certain conditions, including autoimmune disease, a damaged thyroid, iodine intake, and diabetes, the thyroid may either become overactive (hyperthyroidism) or slow down (hypothyroidism).

Dysfunction occurs when the thyroid produces too much or too little thyroid hormone. Both can stop important organs from working well, which can cause a wide range of symptoms.
Hyperthyroidism Symptoms
Dr Ngugi says an overactive thyroid (hyperthyroidism) tends to accelerate the body's metabolism, causing intentional weight loss, fatigue, anxiety or nervousness, rapid heartbeat, hand tremors, excessive sweating, difficulty sleeping (insomnia), and sudden paralysis, among many other symptoms.

For under-active thyroid disorder (hypothyroidism), a patient will experience symptoms such as weight gain, increased sensitivity to cold, muscle weakness, fatigue, a slowed heart rate, depression, and hair loss.

Who Is at Risk of Hyperthyroidism?

According to the National Institutes of Health, 1.2 per cent of people in the United States have hyperthyroidism (NIH).
Although it can happen to men and women, it can happen to women up to 10 times more frequently.
There is no information on hyperthyroidism in Kenya. However, one is more likely to develop thyroid disease if a family has a history of it.

Also, if one has pernicious anaemia (a vitamin B12 deficiency), type 1 diabetes, consumes an iodine-rich diet, takes iodine-containing medications, was recently pregnant, is older than 60, has had thyroid surgery, or has a thyroid issue like goiter, also known as a swollen thyroid gland.

Over the years, there has been an increase in the number of Kenyans with thyroid diseases, including hyperthyroidism, Graves' disease, Hashimoto's syndrome, and thyroid cancer.
Experts believe many people with thyroid diseases do not know they have them, yet those with a proper diagnosis and treatment lead a better quality of life.

How is hyperthyroidism diagnosed?

Dr Ngugi says that it is important to find hyperthyroidism early so that the patient and their doctor can come up with a treatment plan before it causes damage that can't be fixed.
"Only when I have a high index of suspicion will I screen a patient because of the cost of the screening. But the group that should always be screened is pregnant women because the unborn baby is at risk as the thyroid hormone is responsible for brain maturation."

Treatment

Dr Ngugi further explains that treatment for the overactive thyroid will depend on the severity and underlying cause of the patient's symptoms, their age, whether they are pregnant, and other individualised health factors.

It can also be handled through radioactive iodine (RAI) and surgery to remove the thyroid gland.
However, you can only start on the treatments after your thyroid hormone has been controlled.

"Radioactive iodine damages the cells that make thyroid hormones. It is recommended for those who are particularly vulnerable to antithyroid medication and surgery. It's widely considered safe and effective, although you have to observe certain precautions for several days after taking it," Dr Ngugi said.

During surgery, the doctors can either remove part of the gland or the entire gland. Surgery can be an effective and permanent treatment for hyperthyroidism.
"A potential downside of the surgical approach is that there is a small risk of injury to structures near the thyroid gland in the neck, including the nerve to the voice box (the recurrent laryngeal nerve)," said Dr Ngugi.

Hypocalcemia (low calcium in the blood) and airway obstruction are also possible problems, but they happen in less than 5 per cent of surgeries.
In both cases, patients must be on thyroid hormone supplements for the rest of their lives.
Due to his age and underlying illnesses, Mr Fareed has been advised to undergo surgery.

Cost of treatment

Thyroid antibody tests cost about Sh10,000 to Sh12,000, while the thyroid function test is about Sh4,000 plus the drugs; on average, a patient will spend about Sh25,000 on the first visit.
For every visit, a patient has to do a thyroid function test, which will cost between Sh4,500-Sh7,000.

A patient will have to part with Sh3,000 to Sh6,000 as consultation fees to see a specialist doctor, depending on the hospital.
The cost of surgery alone is between Sh60,000 and Sh100,000 in public hospitals and between Sh250,000 and Sh500,000 in private hospitals.

Treatment is not available in regular hospitals; one has to go to a referral hospital. Moreover, the National Hospital Insurance Fund (NHIF) card does not cover the treatment of this disorder.

"We are trying to lobby for the reduction of the costs of testing and drugs so that patients do not struggle for many years with a condition that can be managed before they develop complications of the heart and diabetes later in life," Dr Ngugi adds.
 
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